# PTSD: symptoms, when to get help and which treatments work > Months after the accident, one sudden brake in the street is enough to send your body straight back there. What PTSD is, when it stops being a normal reaction and which treatments work. *https://mypsicotest.com/en/blog/ptsd/ · Published: 2026-09-26 · 13 min read · MyPsicoTest team* It has been eight months since the accident. That night the hospital sent you home without a single broken bone, and everyone agreed you had been very lucky. Yet you still take the long way round to avoid that junction, you wake in the early hours with the sound of the crash still in your head, and whenever someone brakes hard next to you, your heart races as if it were happening again. That has a name. **PTSD**, or **post-traumatic stress disorder**, appears when a terrifying event keeps being lived as a present threat long after it has ended. It is more common than people think, and it affects plenty of people who have never been anywhere near a war. It also has treatments that work well. This guide explains how to recognise it, when an expected reaction stops being one, and what to do to get out of it. ## What is PTSD? The disorder develops after going through, witnessing or learning about a very stressful, frightening or distressing event. The [NHS](https://www.nhs.uk/mental-health/conditions/ptsd-post-traumatic-stress-disorder/) lists among its causes serious accidents, physical or sexual assault, abuse (including childhood or domestic abuse), certain jobs such as police officer, paramedic or healthcare worker, serious health problems such as being in intensive care, a difficult birth or the death of a baby, and war. Nor do you need to have been the one it happened to: seeing it happen to someone else, or hearing that it happened to someone close to you, can be enough. Going through something like this is common. The [World Health Organization](https://www.who.int/news-room/fact-sheets/detail/post-traumatic-stress-disorder) estimates that around **70% of people** will experience a potentially traumatic event during their lifetime, and that only a minority of them, about 5.6%, will go on to develop the disorder. Overall, 3.9% of the world population has had PTSD at some point, and more women are affected than men. ### You do not need to have been in a war Many people link the disorder with the image of the soldier coming home from the front, and so they rule it out in their own case: "mine was a car crash, not a war". The list of causes that health services work with is full of ordinary situations, from a mugging to a birth that went wrong. What they share is how they were experienced from the inside, as something extremely threatening or horrific, and that does not always match how serious they look from the outside. ## PTSD symptoms The WHO groups **PTSD symptoms** into three groups, and to speak of a disorder they have to cause considerable distress and get in the way of daily life, whether at home, at work or with friends. Clinical guidelines also include a fourth group, changes in mood and in how you see yourself, which is the one people least connect with trauma. ### Reliving what happened This is the core symptom. The memory comes back uninvited and with the same fear as on the first day, and not always as a picture: it can be a sound or a smell. It shows up as intrusive memories, as nightmares or, in the most intense cases, as **flashbacks**, moments in which for a few seconds the person feels they are back there and reacts as if it were happening again. This should not be confused with the intrusive thoughts of other conditions, which tend to be absurd ideas or ideas that go against your own values. In PTSD what forces its way in is the memory of something that really happened. If you find them hard to tell apart, we explain the difference in [Intrusive thoughts: what they are, why they appear and when to worry](https://mypsicotest.com/en/blog/intrusive-thoughts/). ### Avoiding anything that brings it back Taking a detour to avoid the place, giving up driving, switching off the news, changing the subject as soon as someone mentions it, or not telling your family or your doctor about it. Avoidance brings relief in the moment, and that is why it settles in. The WHO itself points out the problem: over time it can intensify the intrusive memories, and it is one of the mechanisms that **keep the disorder going**. Every place you stop going to makes the world a little smaller. ### Always on alert The sense of danger stays switched on even when the danger no longer exists. The person watches the street, picks the seat with their back to the wall in a restaurant, and jumps at a slammed door or when someone comes up behind them. It usually comes with irritability and light, broken sleep. If the nights are what weigh on you most, there are specific steps in [Anxiety at night: why it hits when you go to bed and how to stop it](https://mypsicotest.com/en/blog/anxiety-at-night/). ### Changes in mood and in how you see yourself These are the symptoms that mislead people most: negative thoughts about yourself, guilt about what happened or about what you did not do, losing interest in things you used to enjoy, feeling disconnected from yourself and your surroundings (known as **dissociation**), feeling almost nothing or, the other way round, being unable to control what you feel. The NHS adds headaches, stomach problems or pain anywhere in the body with no physical cause to explain it, and problems in relationships, because the person gradually closes off. It rarely comes alone, either. The WHO warns that it is often accompanied by depression, anxiety or the use of alcohol and other substances, and sometimes by suicidal thoughts. If thoughts of harming yourself appear, that is dealt with today: in Spain there is the 024 helpline, free, confidential and available 24 hours a day, and 112 if there is immediate danger; elsewhere, contact your local emergency services. ## PTSD or a normal reaction: when to get help After something like that, it would be strange to feel nothing. Sleeping badly for a few days, replaying the scene, being on edge or crying without quite knowing why are all within what you would expect. The WHO stresses that most people exposed to this kind of event go through a period of distress and then **recover naturally**, and that feeling supported by family and friends lowers the risk of things getting worse. That is why guidelines advise against rushing. The [NICE guideline](https://www.nice.org.uk/guidance/ng116) on this disorder suggests **active monitoring** for people with mild symptoms, below the threshold for the disorder, during the first month: no treatment yet, but a follow-up within a month. It also explicitly advises against so-called psychological *debriefing*, sessions in which those affected are asked to go over what happened shortly after the event. Studies found no benefit from it, and some suggested people ended up worse than if nothing had been done. Waiting has its limits, though. According to the WHO, up to 40% of people with PTSD recover within the first year, which leaves most of them with symptoms after that. It is worth getting help in these cases: - **If the symptoms last longer than a month** and keep getting in the way of your daily life. - **If they appear late.** According to the NHS they can start straight after the event or many months, or even years, later. That is why NICE tells professionals to ask about traumatic experiences even when they are long in the past. - **If they are very intense from the start.** NICE recommends offering trauma-focused cognitive behavioural therapy within the first month to adults with significant symptoms. ## Why it happens to some people and not others It is the question that causes the most guilt: "my sister went through the same thing and she is fine". The WHO describes the disorder as the result of a mix of social, psychological and biological factors, and reminds us that **anyone can develop it**. Some circumstances make it more likely: - having lived through other traumatic events before; - being a woman; - having a family history of mental health problems; - being young or having fewer years of education; - the event being repeated or prolonged, involving a serious physical injury, or seeing other people get hurt. And there is one factor that protects: **the support you get afterwards**. None of this measures anyone's strength. You and your sister did not live through exactly the same thing, even if you were in the same car: each of you arrived with your own history and came out with different support. ## Complex PTSD: when the trauma was repeated The WHO's International Classification of Diseases, in its eleventh edition, also recognises **complex PTSD**. According to the definition used by NICE, it develops after extremely threatening events that are prolonged or repeated and from which escape is difficult or impossible, such as ongoing domestic violence or repeated abuse in childhood. It includes all the symptoms of PTSD plus three more: severe problems regulating emotions, a view of yourself as diminished, defeated or worthless, with deep shame or guilt, and persistent difficulties in keeping relationships and feeling close to others. Treating it takes more time, starting with the time needed to build trust, and it requires making sure the person's life is stable and safe. How it shows up when the origin lies in childhood is covered in [Childhood trauma in adults: how it shows up and what can be done](https://mypsicotest.com/en/blog/childhood-trauma-in-adults/). If the violence is happening now, safety comes first: in Spain the 016 helpline supports victims of gender-based violence, also on WhatsApp at 600 000 016, and leaves no trace on the phone bill; elsewhere, contact your local emergency services. ## PTSD treatment: what works The WHO puts it plainly: there are many effective treatments. The first-choice treatments are **evidence-based psychological interventions**, which can be delivered individually or in groups, and **in person or online**. Two of them have more support than the rest. ### Trauma-focused cognitive behavioural therapy NICE recommends it for adults with symptoms when more than a month has passed since the event, and notes that its benefits are maintained for up to a year, whether there was a single trauma or several. It usually takes **8 to 12 sessions**, a few more if there were several traumas. In them you learn what happens to the body and mind after trauma and how to manage arousal and flashbacks, you process the memory along with the emotions that come with it (shame, guilt, loss, anger), and you look at what the event has come to mean to you, thoughts like "it was my fault" or "nowhere is safe". Little by little you take back what you had stopped doing. The guideline even allows for booster sessions around difficult dates, such as the anniversary. How this approach works in general is explained in [Cognitive behavioural therapy: what it is, how it works and what it treats](https://mypsicotest.com/en/blog/cognitive-behavioural-therapy/). ### EMDR Eye movement desensitisation and reprocessing is the other therapy with the most evidence according to the WHO. NICE recommends offering it to adults when more than three months have passed since a trauma that is not combat-related, also over about 8 to 12 sessions and in phases, and it includes teaching techniques to calm yourself and manage flashbacks. While a specific memory is being worked on, bilateral stimulation is used, normally eye movements, although taps or tones can be used instead. What happens in each phase is set out in [EMDR therapy: what it is, how it works and how it treats trauma](https://mypsicotest.com/en/blog/emdr-therapy-for-trauma/). ![Psychologist taking notes while listening to a client in a therapy session for PTSD](https://mypsicotest.com/assets/img/blog-terapia-estres-postraumatico-1200.webp) ### What about medication? The NHS includes medicines, usually an antidepressant, among the options. NICE keeps them for people who prefer drug treatment and does not put them forward as the first option: in its review, the most studied antidepressants for this disorder turned out to be less effective than any of the recommended psychological therapies. It also advises against giving drugs, benzodiazepines included, to prevent the disorder after the event. If your question comes from the anxiety side, the comparison is in [Anxiety medication or therapy: what works better for anxiety](https://mypsicotest.com/en/blog/anxiety-medication-or-therapy/). ## What you can do in the meantime Self-care does not replace treatment once the symptoms have settled in, but it helps stop them getting worse. This is what the WHO and the NHS recommend: - **Keep your routine** as far as possible: meal times, sleep times, work. - **Talk to someone you trust** about what happened, but only when you feel ready. Nobody has the right to pull the story out of you before then. - **Avoid or cut down on alcohol and drugs**, which make the symptoms worse even if at first they seem to calm them. - **Get moving**, even if it is just a walk a day. - **Look after your sleep**, with regular hours. - **Learn to bring your arousal down** with breathing exercises or progressive muscle relaxation. - **Keep a small diary** to spot what triggers the flashbacks, whether a smell or a sound. Knowing takes away part of the feeling that they come out of nowhere. ## How to start trauma therapy For many people, what holds them back most is picturing the first session: having to tell everything, in detail, to someone they do not know. It does not work like that. Both recommended therapies include explaining what happens after trauma and teaching you to manage arousal and flashbacks, and EMDR is explicitly organised **in phases**. The usual approach is to go into the memory once there are tools to do it. When choosing a professional, check that she is **registered and licensed to practise**, that she has specific training in trauma (trauma-focused CBT or EMDR) and that she carries out an assessment before proposing anything. If someone suggests reliving the event at the first appointment, with no history taken and no preparation, be wary. At MyPsicoTest we recommend [Xènia Capel Salcedo](https://psicologaigualada.es/en/therapist-psychologist-igualada/), a licensed clinical psychologist (COPC 14982) with a master's degree in Clinical Psychology and Psychotherapy. She works on **trauma treatment with EMDR** within an integrative approach built on a cognitive behavioural base, and sees clients in Igualada and Sant Sadurní d'Anoia and also through [online therapy](https://psicologaigualada.es/en/online-therapy-online-therapist/), a format the WHO includes among the ways of receiving psychological treatment for PTSD. The **first information call is free**, so you can tell her where you are and decide afterwards. If you would like to arrive with more than a feeling that you are not well, you can measure what tends to come with trauma. There is no PTSD test on this site, because diagnosis requires a professional assessment, but the [Anxiety Test](https://mypsicotest.com/en/anxiety-test/), the [Depression Test](https://mypsicotest.com/en/depression-test/) and the [Insomnia Test](https://mypsicotest.com/en/insomnia-test/) cover much of what shows up in daily life. You will find them in the [psychological tests](https://mypsicotest.com/en/psychological-tests/) catalogue; they are free and anonymous, and the result is calculated on your own device. And if you are wondering what therapy by video call is like, we cover it in [Online psychologist: how to choose well and what to expect from video-call therapy](https://mypsicotest.com/en/blog/online-psychologist-how-to-choose/). ## Frequently asked questions ### How long after a trauma can PTSD appear? According to the WHO, symptoms usually begin straight after the event or within the following month. That is not always the case: the NHS warns that they can appear many months or even years later, so the time that has passed does not rule out that what you are going through is connected to it. ### Can PTSD be cured? The outlook is good. The NHS notes that PTSD usually gets better for most people, although for some the symptoms are more severe and last longer. The WHO estimates that up to 40% recover within the first year, and for the rest there are effective treatments: according to NICE, the improvements from trauma-focused cognitive behavioural therapy can be maintained for up to a year after treatment. ### How many sessions does PTSD treatment take? The NICE guideline talks about 8 to 12 sessions for both trauma-focused cognitive behavioural therapy and EMDR, and more if there were several traumas. Complex PTSD usually needs more time, starting with the time needed to build trust with the therapist. ### Can PTSD be treated through online therapy? Yes. The WHO includes the online format among the ways of receiving the first-choice psychological interventions. What matters is that the professional has training in trauma and that you can connect from a private space where you can talk calmly. A crisis or an immediate risk does not wait for the session: it is handled first by emergency services. ### Do I have to tell everything that happened in the first session? No. Trauma therapy starts by understanding what is happening to you and learning to manage arousal, and EMDR is explicitly organised in phases. The story comes when you are ready, in the same way that the WHO recommends talking about it with the people around you only when you feel ready. ### Can you get PTSD without living through the event yourself? Yes. According to the NHS, it can appear after seeing it happen to someone else or hearing that it happened to someone close to you. NICE also includes work-related exposure to trauma, even remote exposure, and the NHS mentions jobs such as police officer, paramedic or healthcare worker. ### Is there a test to know if I have PTSD? Diagnosis is made by a professional through a clinical assessment, and no online questionnaire replaces it. MyPsicoTest does not have a specific PTSD test, but it does have screening questionnaires for anxiety, depression and insomnia, three problems that often come with it and that are worth measuring before the first appointment.